Systems and methods for tissue removal

Abstract

Systems and methods for preventing the seeding of cancerous cells during morcellation of a tissue specimen inside a patient's body and removal of the tissue specimen from inside the patient through a minimally-invasive body opening to outside the patient are provided. One system includes a cut-resistant tissue guard removably insertable into a containment bag. The tissue specimen is isolated and contained within the containment bag while the cut-resistant tissue guard protects the containment bag and surrounding tissue from incidental contact with sharp instrumentation used during morcellation and extraction of the tissue specimen. The cut-resistant tissue guard is adjustable for easy insertion and removal such that it securely anchors to the body opening. Protection-focused and containment-based systems for tissue removal are provided that enable minimally invasive procedures to be performed safely and efficiently.

We claim: 
     
         1 . A surgical shield for insertion into and protection of an orifice of a patient; the surgical shield comprising:
 a guard portion formed of cut-resistant material and having a generally tubular shape having an inner surface and an outer surface defining a thickness therebetween; the guard portion defining a lumen extending along a longitudinal axis between a proximal opening at a proximal end and a distal opening at a distal end; and   a batten having a reinforcing portion connected to a handle portion; the reinforcing portion being connected to the guard portion and extending along the longitudinal axis of the guard portion; the handle portion being located at the proximal end of the guard portion and extending away from the proximal end of the guard portion.   
     
     
         2 . The surgical shield of  claim 1  wherein the guard portion comprises a bead having an enlarged thickness around the distal opening such that a distal end of the reinforcing portion and the bead at the distal end are forming a leading end to lead the insertion of the surgical shield. 
     
     
         3 . The surgical shield of  claim 2  wherein the enlarged thickness is non-uniform around the distal opening such that the thickness of the bead is more prominent along the top of the guard portion relative to the bottom of the top portion. 
     
     
         4 . The surgical shield of  claim 1  wherein the batten is located at the top of the guard portion wherein the top of the guard faces the patient's anterior direction. 
     
     
         5 . The surgical shield of  claim 1  wherein the batten is located at the bottom of the guard portion wherein the bottom of the guard faces the patient's posterior direction. 
     
     
         6 . The surgical shield of  claim 1  wherein the distal opening lies in a distal plane that is angled with respect to the longitudinal axis to facilitate insertion of the distal end of the shield into an orifice of the patient. 
     
     
         7 . The surgical shield of  claim 1  wherein the proximal opening lies in a proximal plane that is angled with respect to the longitudinal axis to create a flange at the proximal end. 
     
     
         8 . The surgical shield of  claim 1  wherein the orifice is the vagina and the guard portion is sized and configured such that the bead locates under the pubic bone upon insertion and the proximal opening resides outside of the vagina. 
     
     
         9 . The surgical shield of  claim 1  wherein the handle portion is angled with respect to the reinforcing portion so as to form an L-shaped batten; the handle portion being substantially straight and extending away from the longitudinal axis 
     
     
         10 . The surgical shield of  claim 1  wherein the lumen has an elongate cross-section taken in a plane perpendicular to the longitudinal axis at the proximal end and an elongate cross-section taken in a plane perpendicular to the longitudinal axis at the distal end. 
     
     
         11 . The surgical shield of  claim 10  wherein the lumen has a circular cross-section between the distal end and proximal end. 
     
     
         12 . The surgical shield of  claim 1  further comprising a bead around the proximal opening. 
     
     
         13 . The surgical shield of  claim 1  wherein the reinforcing portion is curved so as to conform to the shape of the inner and outer surfaces of the guard portion. 
     
     
         14 . The surgical shield of  claim 1  wherein the outer surface of the guard portion is curved concave along the longitudinal axis and the inner surface of the guard portion is conformingly curved convex. 
     
     
         15 . The surgical shield of  claim 14  wherein the reinforcing portion is curved so as to have an outer surface that is concave along a length of the reinforcing portion and is convex along a width of the reinforcing portion. 
     
     
         16 . The surgical shield of  claim 14  wherein the reinforcing portion is curved so as to have an inner surface that is convex along a length of the reinforcing portion and is concave along a width of the reinforcing portion. 
     
     
         17 . The surgical shield of  claim 1  wherein the reinforcing portion and the handle portion of the batten have a width of approximately one inch. 
     
     
         18 . The surgical shield of  claim 1  wherein the guard portion is made of flexible material and the batten is more rigid relative to the guard portion. 
     
     
         19 . The surgical shield of  claim 1  wherein the guard portion includes a depending flange portion at the proximal end. 
     
     
         20 . The surgical shield of any one of  claim 1  wherein the guard portion is substantially hourglass shaped.